Abstract
The sporadic and frequently idiosyncratic occurrence of toxicity in several bodily systems during Anafranil therapy has been reviewed. Particular attention is given to the reports between the Madrid World Psychiatric Congress, in 1966, and the marketing of the drug four years later. Whether the changes in haemopoietic, gastro-intestinal or electrolyte parameters represent a drug-related assault on actively dividing or metabolising cells—or whether other preparatory or coincidental factors are important—is a matter of conjecture. Some studies had prompted work in 1970-71 to examine the possibility of adverse effects on calcium metabolism: this is not proven. The possible significance of calcium kinetics in altering the periodicity of affective states is discussed. Little evidence of significant or lasting changes in calcium levels were shown.

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